A radiographic study of dental health in adult patients with dental anxiety

The objective of this study was to compare the dental health in a group of 90 patients with severe dental fear (FP), aged 20-41, with that of a matched control group of ordinary dental patients (OP). All registrations were made from radiographic intraoral full mouth surveys. Mean number of missing teeth among FP and OP patients was 4.4 and 2.5, respectively. On average, FP patients had 19.5 decayed surfaces compared to 7.9 in OP patients. Mean number of filled surfaces was 13.1 and 8.1 in OP and FP patients, respectively. FP patients, on average, had significantly more periradicular bone lesions as well as pronounced marginal bone loss than OP patients. This study showed that dental fear patients in general have a substantially deteriorated dental health compared to ordinary dental patients. Moreover, different dental care habits were evident between FP and OP patients. A progressive severity in dental disease pattern was found among FP patients.

[Panoramic dental studies in systematic screening: useful or superfluous?]

In the framework of a programme of systematic screening, a study of dental health of the population was completed on 791 members of the personnel of a service company together with their spouses. This multicenter study was completed in Belgium, by systematic panoramic dental radiography. Dental anomalies were found in 45.8% of the population studied. These 332 positive dental panoramic radiographies reveal on average 2.4 anomalies for each positive case. These anomalies are significantly (p < 0.05) more frequent among older age groups (51% among those over 45 years of age, 39% among those under 35 years). There is no important difference between the sexes, although a non-significant occurrence of anomalies can be observed among men over 45 compared to women of the same age. An active study of pathologies upon a "healthy" population by means of panoramic and clinical dental examination would therefore seem to be of interest.

The value of panoramic radiographic examination in patients with leukemia before medical management

Panoramic radiographs were completed for patients with leukemia before the start of medical management. The radiographs were taken as part of the patient admission evaluation. Patients were examined and followed throughout the course of their medical management. Panoramic radiographs did not identify pathologic conditions that were not identified clinically or that required management during medical therapy. The radiograph evaluation was of value in correlation with clinical findings and was required before dental treatment. It is concluded that panoramic radiograph evaluation of patients with leukemia is not indicated as part of their routine evaluation and should not be used to screen patients for occult pathosis. The use of these radiographs should be based on history and examination findings.

A survey of disease changes observed on dental panoramic tomographs taken of patients attending a periodontology clinic

Dental panoramic tomographs (DPTs) were taken consecutively of 500 patients referred to a specialist periodontal department by general dental practitioners in order to assist in the diagnosis of the severity of the periodontal disease. Analysis of these DPTs showed 316 (63.2%) of these patients to have some form of dental abnormality unrelated to periodontal disease. The DPT was shown to be a valuable screening technique for clinical practice.

Clinical, radiographic and histological characteristics of secondary retention of permanent molars

Secondary retention refers to the cessation of eruption of a tooth after emergence neither due to a physical barrier in the path of eruption nor as a result of an abnormal position. In this study, the clinical and radiographic features of 81 secondary retained permanent molars in a group of 53 patients were evaluated. Retained molars removed for therapeutic reasons (n = 38) were examined histologically to detect any areas of ankylosis. The first molars in the mandible and maxilla were most frequently affected. The mean infraocclusion at the patients' first visit was 4.3 +/- 1.9 mm. After 6 months, infraocclusion increased in adolescents but was stable in adults. Tilting of the adjacent teeth was observed in 39 cases. A sharp, solid percussion sound and a partial absence of the periodontal ligament space on radiographs were noted in less than one-fifth of the affected molars, while histological evaluation revealed that local areas of ankylosis were present in all cases. From the data relating to the 38 molars removed for therapeutic reasons, the sensitivity of the percussion test and radiographic evaluation was found to be 29 and 21 per cent respectively. During a period of 4 years, six new cases of secondary retention were observed in the same population. From this study it is concluded that secondary retention of permanent molars seems to be associated with focal ankylosis and that percussion tests and radiographs are not sufficiently reliable to exclude the presence of ankylotic areas. The presence of ankylotic areas and tendency of infraocclusion to increase in adolescents but to be stable in adults have major implications for therapy.

The detection of abnormalities in the jaws: a radiological survey

The dental panoramic tomographs of 1000 casual patients attending the Dental Casualty Department of King's College School of Medicine and Dentistry were screened for pathology. The findings are compared with a similar survey conducted 17 years ago at the same institution. The improvement in dental health nationally over this period is not reflected in the findings of this survey.

Secondary retention in the primary dentition

Secondary retention refers to cessation of tooth eruption after emergence. The aim of this study was to evaluate the clinical, radiographic, and histological characteristics of secondary retention as well as the treatment results in a group of thirty-four patients with seventy-seven secondarily retained primary molars. The most important clinical and radiographical criterion for diagnosing secondary retention was infraclusion. Percussion was not a reliable diagnostic tool. Secondary retention in the primary dentition may predispose to a similar disorder in the permanent dentition. In many cases, occlusal disturbances and underdevelopment of the alveolar process disappeared spontaneously after eruption of the permanent successor, unless a similar disorder was observed in the permanent dentition. Active therapy is necessary only in case of severe infraclusion, severe malocclusion, dislocation or agenesis of the successor.

The influence of anatomical, pathophysiological and other factors on periodontal healing after impacted lower third molar surgery. A multiple regression analysis

A multifactorial approach has been used to identify some predictors of postoperative intrabony defects (IBD) on the distal surface of the adjacent second molar (M2) after impacted lower third molar (M3) surgery. The material consisted of 215 lower third molar removals, performed on 144 persons (age range 16-53 years; mean 27.2 years). The postoperative examination took place 2 years after impaction surgery and included both clinical and radiographic variables. Statistically significant (5% significance level) predictors of IBD found in stepwise multiple regression analyses were: (1) preoperative intrabony defect M2 distal; (2) age at the time of surgery; (3) size of contact-area M3/M2; (4) root resorption M2 distal; (5) probing dept distal surface of adjacent first molar postoperatively; (6) pathological follicle M3. The regression model with IBD as regressand produced a total R2 of 0.45. When the regressand was the difference between IBD and the preoperative intrabony defect, the regression analysis explained 62% of the variance (R2 = 0.62). These regression models explained the variance in terms of the size of the remaining postoperative intrabony defect as well as in terms of periodontal healing after impacted lower third molar surgery.

Oral radiology. An expanding technology in search of a direction

Oral radiology still seems to be expanding depending upon increasing availability of dental care. It is widely used more or less routinely, although investigations on efficacy, cost-benefit, and cost-effectiveness are sparse. Such studies should be encouraged and decision-making courses included in dental curricula. Decision-making aids and clinical algorithms should be developed to increase efficiency of oral radiology and to help in the abandonment of its routine use.

Fine-detail panoramic radiography by free-focus radiography. A clinical demonstration of diagnostic radiographs

Previous comprehensive clinical studies have shown that free-focus radiography (FFR) may be used to improve image detail and diagnostic value in panoramic radiography of the teeth and jaws. This study demonstrated the clinical image quality in fine-detail panoramic FFR surveys relative to conventional surveys made by rotational panoramic or intraoral radiography. Cases of particular diagnostic interest with respect to common dental disease and changes in the jaws were included. The radiographic area of diagnostic interest depicted in FFR surveys generally resembled that of conventional dental radiographic surveys with the use of intraoral films rather then those of conventional rotational panoramic surveys.

Validity of the radiographic assessment of ankylosis. Evaluation of long-term reactions in 10 monkey incisors

The accuracy and sensitivity of radiographic assessments of reactive processes in dental tissues were evaluated by comparison of radiographs and histologic sections. Experimental lesions inflicted on the roots of 10 monkey incisors had been observed by means of serially obtained radiographs over a period of 315 to 370 days. The material was used for evaluation of radiographic assessment of ankylosis. For comparative purposes, assessment of the experimental lesion penetrating to the pulp and periapical radiolucency was added. True and falsely positive or negative recordings formed the basis for calculation of the accuracy and sensitivity of the radiographic assessment. The sensitivity, or the observers' ability to detect the actual changes, was high for pulp penetration, intermediate for inflammation, and low for ankylosis.

Radiographic examination of edentulous mouths

Many dentists routinely make radiographs of edentulous patients who request replacement dentures. In the American Dental Associations' Guide to Dental Health, the public is informed that "an x-ray examination is performed only when necessary, not as a routine procedure, and only when the dentist believes such an examination will benefit your health." In light of the changing patterns of the incidence of disease and the cumulative effects of radiation exposure, a study was made of 300 edentulous ridges of dental patients. The study was confined to patients who were treated elsewhere with maxillary and mandibular dentures and who requested new dentures. Patients who had some clinically apparent finding that required radiographic investigation were excluded from the study. Only one impacted tooth that required extraction was found. The diagnosis of edentulous patients seeking treatment with replacement dentures should include a thorough patient history and clinical examination. When radiographs are indicated, they should be made but their routine use in such patients should be discouraged.

Intracoronal radiolucencies within unerupted teeth. Case report and review of literature

A panoramic radiograph obtained during orthodontic treatment revealed an intracoronal radiolucency within an unerupted permanent second molar. This unusual entity was successfully treated by surgical and endodontic intervention, followed by restorative and orthodontic treatment. These treatments enabled the tooth to maintain pulpal vitality, erupt, complete root formation, and function. This report will review the proposed etiologies for this condition, discuss the need for surgical intervention, and present the details of the case.

[Image distortions occurring on intraoral dental x-rays and the ways to overcome them]

Typical errors occurring in roentgenography of the teeth were simulated in a series of experiments. The results evidence that erroneous centering and angle of the x-ray tube inclination, incorrect centering of the film lead to disproportionate distortion of the shape, size, and position of all anatomical elements, that make the results of x-ray examination unreliable. Standardization of methods of intraoral roentgenography implies strict adherence to the rules of roentgenogram recording and treatment; this will permit obtaining high-quality roentgenograms and reduce the x-ray load of the patients.

[Diagnostic value of orthopantomography in otorhinolaryngology]

The present paper emphasizes the diagnostic importance of panoramic radiography in ENT, as demonstrated by representative groups where this specialty is indicated. Pantomographic radiography, which has proved its work in dentistry for many years, often offers a valuable alternative beyond the supplementary evidence provided by routine radiological techniques.

Accuracy of clinical diagnosis for the detection of dentoalveolar anomalies with panoramic radiography as validating criterion

It is noteworthy that little attention has been paid to the balance between economy, discomfort, and risk to the patient (costs) and the clinical significance (benefit) of panoramic radiography as a routine screening procedure. This study used orthopantomographs to validate clinical detection of dentoalveolar anomalies in young children. It appears that 439 children (67 percent) were exposed without benefit from the radiography.

A long-term study of 370 autotransplanted premolars. Part III. Periodontal healing subsequent to transplantation

The purpose of the present investigation was to determine the long-term prognosis of autotransplanted premolars with respect to periodontal healing. The subjects consisted of 195 patients aged 7 to 35 years, with a total of 370 autotransplanted all operated and followed with a standard technique. The observation period ranged from 1 to 13 years. Periodontal healing as demonstrated radiographically was complete in most cases after 8 weeks. Root resorption occurring after transplantation was divided into surface-, inflammatory- and replacement resorption (ankylosis). Root resorption occurred in 52 of the transplanted teeth and was usually diagnosed within 6 months. Root resorption was found to be significantly related to increasing stage of root development and the stage of eruption at the time of transplantation. Subsequent orthodontic movement of teeth with completed root formation at the time of transplantation resulted in a slight increase in the frequency of both surface and inflammatory resorption. The present study indicates that trauma to the PDL of the transplant is the explanatory factor for the development of root resorption.

A subjective study of dental diagnostic utility comparing xeroradiography and film radiography

This study determined the perceived strengths and weaknesses of xeroradiography, D-speed film, and E-speed film for intraoral radiography. Results indicated that xeroradiography was preferred for the imaging of structures useful in periodontics and endodontics whereas film demonstrated a low level of image artifacts and was judged to be better for the imaging requirements of routine restorative dentistry. D-speed film was rated higher than E-speed film. These subjective assessments are similar to previously reported pilot studies but differ from previously published objective studies, which showed no significant difference between the three imaging techniques. Although there are substantial subjective differences between xeroradiography, D-speed film radiography, and E-speed film radiography, all the techniques provide more than the threshold level of necessary diagnostic information and all techniques portray adequate information for evaluation of common abnormalities encountered in the oral cavity.

Widespread radiopacity of jaw bones in familial adenomatosis coli

Abnormalities of jaw bones and teeth were evaluated in 37 patients with familial adenomatosis coli (FAC) by means of orthopantomography. Osteomatous radiopaque lesions were evident in 75.7 percent of FAC patients (focal type: 62.2% and wide spread type: 13.5%), odontomes in 29.7% peripheral osteomas in 13.5%, unerupted teeth in 16.2% and supernumerary unerupted teeth in 16.2%. Five of the 37 FAC patients had an unusual widespread type of radiopacity with other abnormalities. Combined abnormalities were most frequent in patients with this type in comparison with patients with the focal type. Osteomas and peripheral osteomas were revealed in this type with statistical significance. Biopsy performed in one patient revealed an osteoma. These results suggest that the multiple abnormalities seen in oral X-ray examination may predict the occult existence of familial adenomatosis coli and these widespread radiopaque lesions probably represent the most extensive manifestation of FAC.

Secondary retention of permanent molars: a histologic study

The etiology of secondary retention is not well understood, but ankylosis is often considered to be an important factor in primary molars. Data concerning the mechanism of secondary retention in the permanent dentition are insufficient, although a possible role of ankylosis has been suggested. In order to analyze the frequency of occurrence and localization of ankylosis in secondarily retained permanent teeth, 26 secondarily retained molars and for comparison six normal molars were studied histologically. These data were compared with the clinical and radiographic findings. Areas of ankylosis were observed along the roots of all secondarily retained molars. In 81% of the cases these areas were located at the bifurcation and interradicular root surface. No signs of ankylosis were found in normal molars. When these results were compared with the clinical and radiographic data, it was obvious that the latter gave many false negative results, because the areas of ankylosis were often too small to be detected clinically or radiographically.

Tumoral calcinosis with unusual dental radiographic findings

Tumor calcinosis is a rare disease of unknown cause, manifesting itself as abnormal calcifications of cystic masses in the fibrous tissues adjacent to, but not involving, the joint spaces. A family with multiple siblings affected by tumoral calcinosis and found to have unusual dental radiographic findings consistent with varying degrees of expression of dentinal dysplasia is described.